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Bone disease in hemodialysis patients with particular reference to the effect of fluoride

In conclusion, we believe our experience indicates that patients maintained on long-term hemodialysis using fluoridated water for periods of years will encounter an unacceptable frequency and degree of osteomalacia. Although some bone disease, in the form of osteitis fibrosa, occurs in patients using nonfluoridated water, this is usually reversible by treatment with dihydrotachysterol. It therefore seems prudent to use nonfluoridated water in long-term hemodialysis.